Abstract

Background Low socioeconomic status (SES) has been linked to increased risk of hypertension, a known risk factor for cardiovascular
disease. How the risk is altered by intergenerational social mobility is not well known. The aim of this study is to investigate
parental SES, adult SES and the intergenerational social mobility in relation to hypertension risk.

Methods By using data from the Swedish Twin Registry, the authors obtained information about both parental and adult SES and hypertension
in 12 030 individuals born from 1926 to 1958. Generalised estimating equations were used to estimate ORs with 95% CIs.

Results Low parental SES was associated with increased odds of hypertension (OR 1.42, 95% CI 1.14 to 1.76). Low SES in adulthood
was associated with increased odds for women but not for men (OR 1.40, 95% CI 1.15 to 1.70 and OR 1.01, 95% CI 0.83 to 1.24,
respectively). Compared with the stable low social status group, the upward mobile group had lower odds of hypertension (OR
0.82, 95% CI 0.70 to 0.97). Compared with the stable high social status group, the results for the downward mobile group indicated
an increased risk. A co-twin case-control analysis indicated that the results were independent of familial factors.

Conclusions These findings suggest that the risk of hypertension associated with low parental social status can be modified by social
status later in life. Possibly, this could be targeted by public health or political interventions. As parental social status
has an impact on later health, such interventions should be introduced early.

Footnotes

Previous presentations An abstract of the paper has been presented as a poster at the 6th World Congress on Developmental Origins of Health and Disease (DOHaD) in Santiago, Chile, in November 2009.

Funding This study was supported by grants from the Swedish Cancer Society (grants No. 4594-B01-01XAC and 4594-B04-04XAB), the Swedish
Council For Working Life and Social Research (grants No. 2004-1645, 2004-0174 and 2007-0231), the Swedish Research Council
(grants No. K2006-71X-14676-04-2 and K2008-54X-20638-01-3), and the European Union-funded Network of Excellence Lifespan (FP6
036894).

Competing interests None.

Ethics approval The study was approved by the Regional Ethical Review Board in Stockholm, Sweden.